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Exam Code: RDN
Exam Name: CDR Registered Dietitian Nutritionist
Exam Format: Computer-based, multiple-choice questions
Number of Questions: 125–145 (scored questions, plus 25 unscored pilot questions)
Total exam Time: 2.5 hours (150 minutes)
Passing Score: Scaled score of 25 (on a scale of 1–50)
Passing Rate: ~70% (varies slightly each year)

DOMAIN I – PRINCIPLES OF DIETETICS
TOPIC A – Food, Nutrition and Supporting Sciences
- Food science
- Physical and chemical properties of food
- Water
- Vegetables and fruits
- Sugars
- Flours, grains, and cereals
- Milk and dairy products
- Eggs
- Meats, fish, poultry, meat alternatives
- Fats and oils
- Beverages
- Functional foods
- Sensory evaluation of food
- Food safety, processing, preservation, and packaging
- Food biotechnology and genetic engineering

- Scientific basis for preparation and storage
- Function of ingredients
- Techniques of food preparation
- Leavening agents, batters, and doughs
- Effects of techniques and methods on
- Sensory properties
- Nutrient retention
- Roles of food additives

- Composition of food
- Labeling and packaging claims
- Macro and micronutrients sources
- Phytochemicals
- Nutrient databases
- Nutrient analysis
- Principles of normal nutrition
- Function of nutrients and non-nutritive substances
- Macro and micronutrients
- Water
- Fiber, prebiotics and probiotics
- Non-nutritive sweeteners and sugar alcohols
- Herbals, botanicals, and supplements
- Nutrient and energy needs throughout the life span
- Developmental stages and feeding patterns throughout the life span

- Principles of human anatomy, physiology, microbiology, and biochemistry
- Gastrointestinal
- Renal
- Pulmonary
- Cardiovascular
- Neurological
- Musculoskeletal
- Reproductive
- Social determinants of health (e.g., income, culture, social status, education, physical environment, social network, genetics, gender, race, and sexual orientation)
- Nutrition requirements for health promotion and disease prevention

- Education, Communication and Technology
- Components of the educational plan
- Targeted setting/clientele
- Cultural competencies and diversity
- In-service education (e.g., students and health and rehabilitative service providers)
- Patient/client counseling
- Group/individual education
- Goals and objectives (e.g., collaborate with partners and stakeholders)
- Needs assessment (e.g., external constraints, competing programs, illness, and learning needs)
- Individual
- Group
- Content (e.g., community resources, learning activities/methodology, references, handouts, and instructional materials)
- Evaluation criteria
- Budget development
- Program promotion

- Education Theories
- Educational readiness
- Human behavior and change management theory
- Implementation
- Communication
- Interpersonal
- Group process (e.g., interprofessional)
- Teach classes (e.g., culinary demonstrations and grocery tours)
- Interviewing (e.g., techniques of questioning: open-ended, closed-ended, leading)
- Counseling (e.g., techniques: motivation interviewing, behavioral, other)
- Methods of communication
- Verbal/non-verbal
- Written (e.g., reports, grant proposals, other)
- Media (e.g., print, electronic, and social media)

- Evaluation of educational outcomes
- Measurement of learning
- Formative
- Summative
- Evaluation of effectiveness of educational plan
- Documentation
- Client information
- Records
- Confidentiality
- Healthcare and nutrition informatics systems/technologies
- Telehealth and remote health monitoring systems
- Electronic health records (e.g., meaningful use, privacy and protection for Protected Health Information (PHI), use for outcomes and use for National Consumer Panel (NCP))
- Food and nutrient analysis software and databases
- Public policy advocacy and legislation

- Research Applications
- Types of research
- Research process (e.g., secure funding, hypothesis testing, study design, Institutional Review Board (IRB), statistical analysis, results, and discussion)
- Data collection, analysis, interpretation, and outcomes to make decisions
- Application of statistical analysis (e.g., analysis, interpretation, and integration of evidence-based research findings)
- Presentation of research data and outcomes
- Report research findings (e.g., write manuscripts, translation of results for diverse uses)
- Use of grading systems (e.g., Evidence Analysis Library) and the application of evidence analysis as the basis for practice decisions.


DOMAIN II – NUTRITION CARE FOR INDIVIDUALS AND GROUPS
TOPIC A – Screening and Assessment
- Nutrition screening
- Purpose
- Selection and use of risk factors and evidence-based tools
- Parameters and limitations
- Methodology
- Participation in interdisciplinary nutrition screening teams
- Cultural competence
- Prioritize nutrition risk
- Nutrition assessment of individuals
- Dietary intake assessment, analysis, and documentation
- Medical and family history
- Obtain and assess physical findings
- Anthropometric data
- Nutrition-focused physical exam
- Intake and output
- Medication management
- Prescriptions, over-the-counter medications, and supplements
- Medication/food/supplement interactions
- Obtain and assess biochemical data, diagnostic tests, and procedures
- Assessment of energy and nutrient requirements
- Physical activity habits and restrictions
- Comparative standards (e.g., energy requirements and growth)
- Economic/social
- Psychosocial and behavioral factors
- Socioeconomic factors
- Functional factors
- Educational readiness assessment
- Motivational level and readiness to change
- Educational level
- Situational (e.g., environmental, economic, and cultural
- General wellness assessment
- Nutrition assessment of populations and community needs assessment
- Obtain and assess community and group nutrition status indicators
- Demographic data
- Incidence and prevalence of nutrition-related status indicator
- Prevalence of food insecurity
- Review and utilize nutrition screening and surveillance systems (e.g., national, state, and local reference data, NHANES, BRFSS and YRBSS)
- Availability of community resources
- Food and nutrition assistance programs
- Consumer education resources
- Health services
- Studies on food systems, local marketplace, food economics
- Public health programs

- Relationship between nutrition diagnoses and medical diagnoses
- Pathophysiology
- Identifying medical diagnoses affecting nutrition care
- Determining nutrition risk factors for current medical diagnoses
- Determining nutrition factors for groups
- Data sources and tools for nutrition diagnosis
- Organizing assessment data
- Using standardized language
- Diagnosing nutrition problems for individuals and groups
- Making inferences
- Prioritizing
- Differential diagnosing
- Etiologies (e.g., cause/contributing risk factors)
- Identifying underlying causes and contribution risk factors of nutrition diagnoses
- Making cause and effect linkages
- Signs and symptoms (e.g., defining characteristics)
- Linking signs and symptoms to etiologies
- Using subjective (symptoms) and/or objective (signs) data

- Nutrition care for health promotion and disease prevention
- Identification of desired outcomes/actions
- Evidence-based practice for nutrition intervention
- Evaluation of nutrition information
- Food fads
- Health fraud
- Health and wellness promotion and risk reduction programs
- Implementing care plans
- Nutrition recommendations to promote wellness
- Communication and documentation
- Medical Nutrition Therapy
- Identify desired outcomes and actions
- Relationship of pathophysiology to treatment of nutrition-related disorders
- Critical care and hypermetabolic states
- Disordered eating and eating disorders
- Food allergies and intolerance
- Immune system disorders, infections, and fevers
- Malnutrition (e.g., protein, calorie, vitamin and mineral)
- Metabolic
- Endocrine
- Inborn errors of metabolism
- Oncologic and hematologic conditions
- Organ system dysfunction
- Gastrointestinal
- Renal
- Pulmonary
- Cardiovascular
- Nervous system
- Musculoskeletal
- Reproductive
- Orthopedic
- Wounds
- Obesity
- Mental/Behavioral health and addiction
- Gastrointestinal and bariatric surgery
- Determine energy/nutrient needs specific to condition
- Determine specific feeding methods
- Oral
- Composition/texture of foods and liquids
- Chewing difficulty
- Swallowing difficulty (International Dysphagia Diet Standardization Initiative)
- Diet patterns/schedules
- Diet modification for diagnostic test
- Modified diet products and food supplements
- Adaptive equipment
- Breastfeeding
- Enteral and Parenteral nutrition
- Formulas and calculations
- Routes, techniques, equipment
- Complications
- Integrative and functional care, herbal therapy
- Implementing care plans
- Nutrition therapy for specific nutrition-related problems
- Basis for quality practice (e.g., evidence-based guidelines, standardized processes – National Consumer Panel (NCP), regulatory and patient safety issues)
- Counseling and training (e.g., nutrition plans, medical devices and formula preparation
- Communication and documentation
- Patient rounds
- Care conference
- Coordination of care/interprofessional coordination
- Discharge planning
- Recommend appropriate physical, social, behavioral or psychological services
- Referral to community resources (e.g., WIC and home-delivered meals)
- Implementation and promotion of national dietary guidance
- MyPlate and other diet instructional tools
- Dietary Guidelines for Americans and Healthy People
- State and community resources and nutrition-related programs
- Block grants to states
- Federal and state funded food and nutrition programs
- Community-based interventions
- Development of programs and services
- Identification and attainment of funding
- Resource allocation and budget development
- Provision of food and nutrition services to groups

- Monitoring progress and updating previous care
- Monitoring and determining tolerance to interventions (e.g., medications, tube feeding, parenteral nutrition, medical nutrition and dietary supplements)
- Measuring outcome indicators using evidence-based guides for practice
- Selecting indicators
- Using reference standards
- Explaining variance
- Evaluating effectiveness and outcomes of nutrition interventions for individuals and populations
- Direct nutrition intervention outcomes
- Clinical and health status outcomes
- Patient-centered outcomes
- Resource utilization outcomes
- Relationship with outcome measurement systems and quality improvement
- Determining continuation and transition of care
- Continuing and updating care
- Discontinuing care

DOMAIN III – MANAGEMENT OF FOOD AND NUTRITION PROGRAMS AND SERVICES (21%)
TOPIC A – Functions of Management
- Functions
- Planning
- Short and long range
- Strategic and operational
- Policies and procedures
- Emergency preparedness
- Organizing
- Schedules and FTE allocations
- Department or unit structure
- Processes, procedures, and improving productivity
- Resources
- Directing
- Coordination
- Delegation
- Communication
- Motivation strategies
- Leadership theories
- Management theories
- Controlling
- Establishing standards
- Monitoring established plans
- Developing corrective actions
- Staffing
- Forecasting personnel needs
- Alignment of personnel
- Management characteristics
- Skills
- Technical
- Human
- Conceptual
- Roles
- Informational
- Conflict resolution
- Problem-solving
- Decision-making
- Other (e.g., change management)
- Traits
- Management styles
- Leadership styles
- Interpersonal styles
- Managing a diverse workforce
- Emotional intelligence

TOPIC B – Human Resource Management
- Employment laws and regulations
- Compliance (e.g., Equal Employment Opportunity Commission (EEOC), Americans with Disabilities Act (ADA), Occupational Safety and Health Act (OSHA) or other)
- Credentialing and licensure
- Unions and contracts
- Employment standards
- Job analysis
- Job specifications
- Job descriptions
- Employment processes
- Recruitment and selection, interviewing skills
- Orientation and training
- Performance improvement, development, and evaluation
- Discipline
- Grievance
- Compensation
- Retention and turnover
- Personnel records
- Cultural humility/competence (e.g., diversity and inclusion, equitable workplaces, scheduling implications, training, etc.)

TOPIC C – Financial Management
- Budgeting processes and fiscal periods
- Budget procedures
- Types
- Operational
- Capital
- Methods
- Incremental
- Performance
- Zero-based
- Flexible
- Fixed
- Components
- Types of expenses
- Revenue streams
- Profitability
- Resource allocation
- Financial monitoring
- Accounting principles
- Cash control and auditing
- Financial statements
- Financial analysis

TOPIC D – Marketing and Public Relations
- Marketing analysis
- Process
- Identification of target market
- Determination of needs/wants
- Marketing mix
- Customer satisfaction
- Documentation and evaluation
- Pricing
- Strategies
- Breakeven
- Revenue-generating
- Loss leader
- Rationale
- Public relations
- Media relations
- Social networking
- Campaign development
- Customer service
- Marketing mix principles
- Product
- Place
- Price
- Promotion

TOPIC E – Quality Management and Regulatory Compliance
- Regulatory guidelines (e.g., federal, state, local and accreditation agencies)
- Food and nutrition policy (e.g., older adults act legislation, farm bill)
- Federal feeding programs (e.g., Supplemental Nutrition Assistance Program (SNAP), National School Breakfast Program and National School Lunch Program, Child and Adult Care Food Program (CACFP))
- Coding and billing, insurance requirements
- Accreditation agencies (e.g., The Joint Commission, Centers for Medicare & Medicaid Services (CMS), DNV GL Healthcare)
- Process, implementation, evaluation
- Cost/benefit analysis
- Productivity analysis
- Program and product analysis
- Tools (e.g., Kaizen, Total Quality Management, Lean Six Sigma)
- Scope of practice and standards of professional performance (SOP, SOPP)
- Code of ethics

DOMAIN IV – FOODSERVICE SYSTEMS (13%)
TOPIC A – Menu Development
- Menu
- Patient/resident
- Multi facility
- Single site
- Commercial
- Non-commercial
- Menu development
- Master menu
- Guidelines and parameters
- Sensory characteristics
- Nutritional adequacy
- Cost
- Regulations
- Modifications
- Diet/disease states/life span
- Preferences/substitutions
- Nutritional adequacy
- Food allergies and sensitivities
- Cultural/religious
- Vegetarian/vegan
- Demographics
- Satisfaction Indicators
- Customer/patient evaluation
- Sales data
- Employee satisfaction
- Operational influences
- Facility/equipment
- Labor
- Budget
- Organizational philosophy (e.g., mission, vision, culture, values)
- External influences
- Trends
- Seasonality
- Emergency/disaster management
- Product availability

TOPIC B – Procurement, Production, Distribution, and Service
- Procurement, receiving, and inventory management
- Procurement principles, concepts, and methods
- Bid process and contract implementation
- Specification development
- Group purchasing/prime vendor
- Ethics
- Foodservice management software
- Procurement decisions
- Product selection/yield (e.g., fresh, frozen, prepackaged)
- Quality standards
- Product packaging
- Cost analysis
- Receiving and storage
- Equipment and methods
- Records
- Security
- Safety and sanitation
- Inventory management
- Control procedures (e.g., par levels, rotation and minimum/maximum)
- Issuing procedures
- Inventory technology
- Principles of quantity food preparation and processing
- Cooking methods
- Equipment
- Preservation and packaging methods
- Modified food preparation
- Food production control procedures
- Standardized recipes
- Ingredient control
- Portion control and yield analysis
- Forecasting production
- Production scheduling
- Food waste management
- Inventory management
- Safety and sanitation
- Production systems
- Conventional
- Commissary
- Ready-prepared (e.g., cook-chill, cook-freeze)
- Assembly/serve
- Display cooking
- Distribution and service
- Type of service systems (e.g., centralized, decentralized and room service)
- Equipment
- Packaging

TOPIC C – Sanitation and Safety
- Sanitation
- Sanitation practices and infection control
- Personal hygiene
- Food and equipment
- Waste disposal
- Food handling techniques
- Food laws and regulations (e.g., Food Code, government and other agencies)
- Food safety
- Principles
- Contamination and spoilage
- Microbiological control
- Signs and symptoms of food borne illness
- Allergens/cross contact
- Food safety management
- Standard operating procedures
- Time and temperature control
- Documentation and recordkeeping
- Recalls
- Operational emergencies
- Bioterrorism
- Employee behaviors and training
- Inspections and audits
- Hazard Analysis Critical Control Point (HACCP)
- Safety
- Employee
- Universal precautions
- Equipment use and maintenance
- Personal work habits
- Protective equipment
- Practices
- Environmental conditions
- Regulations
- Fire safety
- Accident prevention
- Occupational health and safety guidelines
- Documentation and recordkeeping
- Reporting (e.g., work restrictions, injuries, accidents, Workers Compensation, spills, falls, exposures)

TOPIC D – Equipment and Facility Planning
- Facility layout
- Equipment and layout planning
- Menu
- Flow of food
- Service systems
- Safety and sanitation
- Privacy and accessibility
- Codes and standards
- Budget (e.g., equipment, staff, operational inputs)
- Staffing (e.g., skill and number)
- Planning team
- Composition
- Roles and responsibilities
- Project management schedule
- Equipment
- Specifications
- Selection
- Installation schedule
- Staff training
- Sustainability
- Food and water
- Non-food
- Supplies
- Equipment
- Waste management
- Storage
- Reduce, reuse, recycle
- Disposal
- Emergency preparedness and contingency planning
- Inventory (e.g., food, water, and supplies)
- Technology
- Operational inputs (e.g., utilities)
- Staffing
- Safety plan